Hepatic resection has been the main form of the treatment of liver benign and malignant tumors. With the popularity of applications of minimally invasive techniques in surgery in recent years, laparoscopic hepatectomy(LH) application has also achieved a rapid development. It' s advantages are known as a small open incision, light systemic response and rapid recovery, meanwhile it can also attain the same efficiency as the open surgery does. However, there also exist disadvantages, such as complicated conduct, expensive instruments, and bleeding problems. This article reviews the process of development of laparoscopic liver resection, and elaborates its current status, existing problems, and evaluation of its treatment and efficiency.

Severe acute pancreatitis (SAP) is a critical disease which has a high mortality. In order to make the diagnosis and treatment much more promptly, rationally and effectively, this article briefly introduces some methods for assessment of the severity and risk of SAP by clinical manifestation, risk factors,scoring systems, radiology and laboratory examinations.

Objective To provide vessel anatomical materials guidance for endovascular aortic repair,the branches artery of thoracic aortic was studied by CT angiography (CTA).Methods From January 2008 to February 2012,739 adult cases' CTA data were collected,all cases performing thoracic CTA in Wuhan General Hospital of Guangzhou Command.We measured the diameter and/or leugth of the ascending aorta,aortic arch and branches artery of aortic arch,and made an analysis.Results The aortic arch includes standard and variant types.Standard type is common,which accounted for 91.1％ of the total number,while variant type accounted for 8.9％.In the standard aortic arch of patients,the diameter of aortic arch above the opening of coronary artery (CA) was (35.7 ±4.3) mm,the diameter of ascending aortic arch at the opening of brachiocephalic trunk (BCT) was (33.6 ±4.2) mm,the diameter of aortic arch between the BCT and the left common carotid artery (LCCA) was (29.4 ± 5.7) mm,the diameter of aortic arch between the LCCA and the left subclavian artery (LSA) was (27.6 ± 4.2) mm,the diameter of descending aortic at the opening of the LSA was (25.4 ± 4.5) mm,the diameter of the head BCT from aortic arch was (12.9 ±0.9) mm,the diameter of the head LCCA from aortic arch was (8.5 ± 0.7) mm,the diameter of the head LSA from aortic arch was (10.4 ± 1.1) mm,the length of aorta between the CA and the BCT was (53.3 ±12.5) mm,the length of aortic between the BCT and the LCCA was (4.7 ± 1.5) mm,the length of aortic between the LCCA and the LSA was (7.9 ± 2.6) mm,the length between the opening of BCT and the right subclavian artery (RSA) was (41.1 ± 8.2) mm,the length between the opening of LSA and the opening of left vertebral artery was (38.5 ±5.7) mm,the angle between the horizontal of BCT and the LCCA and the sagittal plane was (71.2 ± 7.2) °,the angle between the plane of LCCA and the LSA and the plane of sagittal was (31.1 ± 2.9)°.Conclusions The CT data of the thoracic aorta can be used as reference for production of stents and guide releasing the stents in endovascular repair.

Objective To evaluate arch replacement in islet fashion combined with intraluminal-including technique.Methods From Aug.2011 to Mar.2012,19 patients with type A aortic dissection needed arch replacement were selected,whose cephalo-brachial artery and left common carotid artery were intact or left subclavicular artery alone was involved,Sixteen patients were male.Mean age was (49.6 ± 5.7) years.Urgent surgery and red surgery were completed in 13 cases,6 cases and 1 case,respectively.The arch replacement was performed in a modified islet fashion,remaining the adventitia and trimming intima,constituting a common opening with the proximate end of stented elephant trunk in side-to-side manner by using intraluminal anastomosis technique.This common opening was anastomosed with the distal end of the ascending aortic Dacron graft,completed the procedure of arch replacement.If left subclavicular artery was involved by dissection or it was displaced pathologically as to expose difficultly,it should be covered by the stented elephant trunk,and be transplanted to left common carotid artery in end-to-side manner.Finally,the entire Dacron graft was wrapped by remained adventitial coat using including technique,with a shunt connecting to right atrium.Results Mean duration of cardiac pulmonary bypass,aortic cross clamp and selective cerebral perfusion was (215 ±54),(93 ± 18) and (30 ±6) minutes,respectively.In one case with delayed sternum closure due to extensive bleeding,the mean chest tube output in first 24 hours was (926 ±322) mL,the mean duration of postoperative ICU was (78 ±21) hours; none of the patients was reopened for bleeding.Postoperative hypoxemia,transient neurologic dysfunction,and hematosepsis occurred in 3 cases,1 case and 1 case,respectively.One patient needed re-intubation attributing to pulmonary infection.There was no complication of permanent neurologic deficit or postoperative visceral mal-perfusion.All patients survived and were discharged from hospital.Severe complication was not observed at follow-up of 1 to 5 months.Conclusions The modified aortic arch replacement procedure,which adopt islet fashion combined with intraluminal inclusion technique,characterized by its feasibility,safety,reproduction and easy to control bleeding,may be considered as an alternative approach for managing arch disease.Its short-term outcomes were competitive and prospective was promising.

Objective To investigate the consistent long-term clinical efficacy of the procedure for prolapsed hemorrhoids (PPH) treatment for hemorrhoids.Methods Data of 87 patients with third-and fourth-degree hemorrhoids treated by surgical procedure for prolapsed hemorrhoids were collected.In all cases,third-degree hemorrhoids in 65 cases,fourth-degree hemorrhoids in 22 cases,median followed up after PPH was (3.8 ± 0.5) years.The long-term efficacy and the occurrence of complications were followed up to assess the effect of surgical procedure for prolapsed hemorrhoids.Results In patients with third-degree hemorrhoids,bleeding recurred in 2 cases (3.1％) for again bleeding,for anal bulge in 4 cases (6.2％).In patients with fourth-degree hemorrhoids,prolapse recurred in 2 cases (9.1％) for bleeding in 5 cases (22.7％).anal bulge 3 patients (13.6％),defecation difficult in one case (4.5％),one-degree of fecal incontinence in 1 case (4.5％),no other complications found,such as anal pain,anal stenosis,foreign body discomfort and fecal urgency.The chi-square test for comparison analysis suggested that:third-degree hemorrhoids postoperative prolapse and bleeding recurrence rate was significantly lower than fourth-degree hemorrhoids.Conclusions Procedure for prolapsed hemorrhoids treatment for hemorrhoids is safe and feasible,has small trauma,little pain,and definite efficacy,fewer complications,shorter hospital stay,lower reoperation rate,etc.But the long-term efficacy for third-degree hemorrhoids is superior to the fourth-degree hemorrhoids.

Objective To explore the consistency between preoperative clinical TNM stage and postoperative pathological TNM stage of gastric cancer and look for the underlying reason.Methods Sixty-four patients of gastric cancer with complete clinical data from December 2010 to December 2011 in Gansu Provincial Hospital were enrolled into this study.All cases were performed postoperative pathological TNM staging according to the TNM stage criteria of gastric cancer from JGCA(the 14th edition,2010),and the results were compared with preoperative TNM staging,then we studied the consistency of T staging,N staging and M staging using SPSS 18.0.Results The Kappa value from T staging of preoperative and postoperative was 0.729,showing a good consistency.The N stage' s consistency was lower,Kappa value being only 0.216.For M staging,Kappa value 0.743,having a good consistency.Conclusions According to the General Rules for Gastric Cancer Treatment,a accurate TNM staging and individual treatment plan can be made for gastric cancer patients in clinic.But the overestimate and underestimate still existed,especially in N staging.Therefore,making a accurate judgment for N staging according to all kinds of preoperative clinical data and images is the key to improvement of preoperative TNM staging accuracy and treatment.

Colorectal cancer is a common malignancy in China.The incidence of it showed an increasing trend with the economic development,living standards improvement and lifestyle changes.The traditional treatment methods include surgery,radiotherapy and chemotherapy.In recent years,hyperthermia has become a method for treating tumor.Hyperthermia kills tumor cells by thermal effect and no-thermal effect.Not only does it have a direct therapeutic effect on tumor cells,hyperthermia also has some synergy combined with radiotherapy and chemotherapy.Hyperthermia combined with conventional therapy can improve the local control rate and extend survival for patients.In this paper,the efficacy of hyperthermia has been reviewed,combined with a variety of treatment methods for colorectal cancer in China.

Tumor invasion and metastasis are regarded as main reasons for the failure of therpy and the reason of patients death.The mechnism of tumor metastasis is still uncertain.The pre-metastatic niche hypothesis provides us with new ideas to discover the mechnism.Numerous materials are involved in the formation of the pre-metastatic niche according to this hypothesis,including bone marrow-derived cells,microvesicles,exosomes,CD44,and so on.A further research on this hypothesis helps to deeply understand the nature of metastasis and leads clinical doctors to explore novel targets for clinical diagnoses and therapies.

Macrophages,as an important member of innate immune system,constitute a major component of the microenvironment of tumours,and play an important role in the occurrence and development of tumor.According to particular phenotypes and functions,macrophages can be divided into M1 macrophages and M2 macrophages.In the research of breast cancer,lung cancer,gynecological malignancies,researchers have found that tumor-associated macrophage has the similar phenotype and function of M2 macrophages.Tumor-associated macrophage can promote the formation of new blood vessels and lymphatic vessels in tumor tissue,thus contributing to the occurrence and development of tumor.The relation between tumor-associated macrophage and poor prognosis was also be found.The tumor microenvironment can affect the phenotype and function of macrophages,such as TGF,IL-10 and PGE-2.This paper reviewed the role and mechanism of macrophages in the tumorigenesis.

As a transmembrane glycoprotein receptor family,integrin family mainly mediats cell-matrix interactions,participates in the function,through the unique bi-directional signal transduction pathways,played an important role in tissue repair process.The purpose of this article is to summarize the role of integrin family in the repair of tissue damage and sum up the current research progress.